Station 83
Thomas Reid
Age: 39 years old male
Doctor
Patient’s Data
Patient’s name: Thomas Reid
Age: 39-year-old male
Past medical history:
- Rheumatoid arthritis (Known to Rheumatology – under shared care agreement)
Drug history
- Methotrexate 15 mg once weekly (Every Monday)
- Folic acid 5mg weekly (Every Friday)
Alerts and QOF
- Missed last 2 blood test appointment for methotrexate bloods
Recent notes/ consultation
Bloods done 7 months ago- filed as satisfactory
| Test | Result | Normal Range |
|---|---|---|
| Haemoglobin (Hb) | 140 g/L | 130–180 g/L (male) |
| White Cell Count (WCC) | 6.5 x10⁹/L | 4.0–11.0 x10⁹/L |
| Neutrophils | 3.8 x10⁹/L | 2.0–7.5 x10⁹/L |
| Platelets | 250 x10⁹/L | 150–400 x10⁹/L |
| Sodium | 140 mmol/L | 135–145 mmol/L |
| Potassium | 4.2 mmol/L | 3.5–5.0 mmol/L |
| Creatinine | 80 µmol/L | 60–120 µmol/L (male) |
| eGFR | >90 mL/min/1.73m² | >60 mL/min/1.73m² |
| ALT | 22 U/L | 10–50 U/L |
| AST | 18 U/L | 10–40 U/L |
| ALP | 78 U/L | 30–130 U/L |
| Bilirubin | 12 µmol/L | < 21 µmol/L |
| Albumin | 42 g/L | 35–50 g/L |
| CRP | 4 mg/L | < 5 mg/L |
| ESR | 8 mm/hr | < 15 mm/hr (male under 50) |
Note entry (4 months ago) – by Mr Rahul Mehra (Pharmacist access role):
Presenting complaint: Attempted to contact patient by phone three times and sent text regarding missed methotrexate monitoring appointment. No response received.
Plan: Methotrexate withheld as per safety protocol. Notification letter sent to patient’s home address.
Current Status: Patient booked an urgent appointment to discuss some concerns.